Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $954.99	Facility		$457.09	$457.09	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $537.03 / $954.99	Professional		$407.38	$537.03	$954.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $741.31 / $954.99	Professional		$660.69	$741.31	$954.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,819.70 / $6,456.54	Facility		$1,122.02	$1,819.70	$6,456.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $1,122.02	Facility		$588.84	$588.84	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $1,071.52	Professional		$426.58	$426.58	$1,071.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,096.48 / $1,348.96	Professional		$794.33	$1,096.48	$1,348.96
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Professional		$1,202.26	$1,202.26	$1,202.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $707.95	Professional		$489.78	$489.78	$707.95
United Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $741.31 / $1,513.56	Facility		$616.60	$741.31	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $467.74 / $776.25	Professional		$389.05	$467.74	$776.25